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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED s Date: a � \ Permit Number: ^-- _ RECEI'.'^D DEC0 3 1015 '! -- - -- Building Permit Application Planning and Development Services Building and Code Regulation Division ]f 2300 Virginia Avenue,Fort Pierce FL 34982 K� Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential G, PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W V� o- Address• 5 Legal Description: (I)CP ill-s COUv 0i::]1-11 1')i k / cl- lilt. Property Tax ID#:1g/el- 701 _00(1_000-(a Lot No. Site Plan Name: Block No. Project Name:_a i V Setbacks Front Back: Right Side: Left Side: DETA E D ..5 QIP ION OF :a ChO�r�Q.Q OCA ( d 0c)(, /10 S/Zc Chan Q . �J ills, Additional work to be performed uncle r tispermit-check all appy: HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof f Total Sq. Ft of Construction: Sq. Ft,of First Floor: Cost of Construction:$r�9'z� . Utilities: Sewer Septic Building Height: WN W1� 5 .` CUN R�Cl'OR: Name �,. 1 Name: ,-TCttWes'�6—Tc�L'4S Address: 1. P, Companya(n City: i07 0 State:L Address:_1:2�,H In ( `79 Td-i Cti-j— A� Zip Code:3 Fax City: L.0 �ffi 1DL-zec-a C. State:-F"— Phone No. -t/O?-(4 Zip Code:33y 1 2— Fax: 5-?d .1�r5S C/o E-Mail: Phone No. GS'^Q), Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: C�� Q a*3-?531 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i Ula' I AI_CONS'R 1©N IEN LAW INF�O'R�MAi"I-UN: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: of Applicable Name: Name: Address: Address: City: State' City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: 1ot Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of apeftmit. St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules;bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and-accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing,consult-With lender or an attorney before commencing work or recording our Notice of Commencement. S Signature of Owner/Lessee/,Agent•_ Ignature o ontractor/License Holder STATE OF STATE OF FLORID COUNTY OFORIv(_V U� COUNTY OF -I PG;(` The forgoing instrument was acknowledged before me The forgoing i trument was acknowledged before me this J�__day of CrYlbef 20 LIby this day of[ Et e-r.20 l S by �<Gt 1 V ))' Lb VI S (Name f person acknowledging) (Name of person acknowledging) {Signature of.Nota Pulbli S afe'of Florida)`__ Si a re of tory Pufil'---St a of Flb`�da 10s�#�'-c�,tst��s�� . g - v;-�n,,ci112:to Personally Known P o c d e if Personally Known Qit<?.roducecGtdentificatjon,.:•, Type of Iden ro uce Type of Identification Prodi`Icer�:u'`__ F�t.., r' aA r �� �P NOD�`��5910 . }3sa•" Commission Commission No. (Seal) My Comm.Eipkti Mir d.2019- . ohm AM Revised 0 /f5/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS l